Rural areas lack resources for handling HIV/AIDS

Robin Lewy of the Rural Women's Health Project speaks during a conference at the Matheson Museum to address the rise of HIV/AIDs in North Florida, discussing the reasons, the stigma associated with the disease, and local resources to contain it, in Gainesville on Friday.

Published: Friday, November 30, 2012 at 6:38 p.m.

Last Modified: Friday, November 30, 2012 at 6:38 p.m.

HIV/AIDS has traveled north in Florida. When the epidemic emerged a few decades ago, most cases in the state were concentrated in Miami, but over time, it's become prevalent in the northern part of the state.

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What hasn't come with it, however, are many of the educational and medical resources for preventing and treating the illness.

This was one of the messages at Friday's "Bridging Voices" forum to kick off World AIDS Day today. Sponsored by the Gainesville-based Rural Women's Health Project, a nonprofit focused on improving women's health care, the forum highlighted results of the SHARP (State Healthcare Access Research Project) report on HIV/AIDs in North Florida.

"The further north in Florida you go, the further south you go," said Amy Rosenberg, the associate director and clinical instructor at the Center for Health Law and Policy Innovation at Harvard Law School.

The area between Gainesville and Georgia has 1,537 AIDS patients, and 2,617 people infected with the HIV virus, the report shows. Men with AIDS outnumber women with the disease 4 to 1, and they are disproportionately African-American. Between Ocala and Orlando, there are 1,338 AIDS patients, 2,215 people infected with HIV and a 2.7 to 1 men to women ratio of AIDS patients.

"A lot of the challenges here are similar to what you find in other Southern states, with a rural population and pretty pervasive stigma," said Rosenberg, who presented the SHARP report Friday at the Matheson Museum in Gainesville.

"Traditionally, (the area) has not had great health outcomes or its fair share of resources," Rosenberg said.

For example, one challenge has been financing transportation for AIDS patient to get to their doctor's appointments.

"Transportation can tie into stigma," Rosenberg said. "If you ask someone for a ride, and they want to know why. Plus, things are far apart in rural areas."

The report makes recommendations for improving access to care and combating stigma.

Rosenberg said the Affordable Care Act has a lot of funding opportunities that will help HIV/AIDS patients, especially Medicaid expansion and the subsidies foreseen by the insurance exchanges. "A lot of the challenges we've seen could be addressed with people having coverage," she said.

Notably, the ACA also mandates insurance companies to pay for HIV testing in everyone aged 15-65, according to new United States Preventive Task Force recommendations.

Reducing stigma associated with the disease is arguably more challenging, and should be a personalized effort — in other words, encouraging people to have contact with infected people — instead of a standard "AIDS 101" educational approach, Rosenberg said.

"We don't want this to be something people are afraid of," said Robin Lewy, the director of development at the Rural Women's Health Project, which was one of the 25 nonprofits collaborating with the SHARP report. Lewy added that social media should have a role in educating people about being tested for HIV and the disease in general.

Targeting different communities like churches is another recommended strategy. "We need to educate our ministers," said Marvene Edwards, 56, a Gainesville resident living with HIV who spoke at Friday's forum. "If they call it a curse, and someone in the audience is positive, then you're scarring them from the inside out."

"We need to sit down with the pastors because we are the ones dealing with it," Edwards continued, adding that it's important to convey the message that, "We can live with the virus. We don't have to let it dictate our lives."

Other challenges include combating prejudice among law enforcement officials, employers and medical providers who "profile" patients when deciding who should get tested for the virus. They often do not test middle-aged caucasian women, for example, Edwards said.

Robin Chatmon, 57, another Gainesville resident living with HIV, said she lost her job shortly after she was diagnosed with HIV. She'd been working as a certified nursing assistant in Lake City when one night she got a call from her supervisor telling her, without any explanation, that Chatmon's services were no longer needed.

"As a nurse, she should have known that HIV doesn't spread through touch, that I can cook dinner for you and you're not going to get it," Chatmon said.

<p>HIV/AIDS has traveled north in Florida. When the epidemic emerged a few decades ago, most cases in the state were concentrated in Miami, but over time, it's become prevalent in the northern part of the state.</p><p>What hasn't come with it, however, are many of the educational and medical resources for preventing and treating the illness.</p><p>This was one of the messages at Friday's "Bridging Voices" forum to kick off World AIDS Day today. Sponsored by the Gainesville-based Rural Women's Health Project, a nonprofit focused on improving women's health care, the forum highlighted results of the SHARP (State Healthcare Access Research Project) report on HIV/AIDs in North Florida.</p><p>"The further north in Florida you go, the further south you go," said Amy Rosenberg, the associate director and clinical instructor at the Center for Health Law and Policy Innovation at Harvard Law School.</p><p>The area between Gainesville and Georgia has 1,537 AIDS patients, and 2,617 people infected with the HIV virus, the report shows. Men with AIDS outnumber women with the disease 4 to 1, and they are disproportionately African-American. Between Ocala and Orlando, there are 1,338 AIDS patients, 2,215 people infected with HIV and a 2.7 to 1 men to women ratio of AIDS patients.</p><p>"A lot of the challenges here are similar to what you find in other Southern states, with a rural population and pretty pervasive stigma," said Rosenberg, who presented the SHARP report Friday at the Matheson Museum in Gainesville.</p><p>"Traditionally, (the area) has not had great health outcomes or its fair share of resources," Rosenberg said.</p><p>For example, one challenge has been financing transportation for AIDS patient to get to their doctor's appointments.</p><p>"Transportation can tie into stigma," Rosenberg said. "If you ask someone for a ride, and they want to know why. Plus, things are far apart in rural areas."</p><p>The report makes recommendations for improving access to care and combating stigma.</p><p>Rosenberg said the Affordable Care Act has a lot of funding opportunities that will help HIV/AIDS patients, especially Medicaid expansion and the subsidies foreseen by the insurance exchanges. "A lot of the challenges we've seen could be addressed with people having coverage," she said.</p><p>Notably, the ACA also mandates insurance companies to pay for HIV testing in everyone aged 15-65, according to new United States Preventive Task Force recommendations.</p><p>Reducing stigma associated with the disease is arguably more challenging, and should be a personalized effort — in other words, encouraging people to have contact with infected people — instead of a standard "AIDS 101" educational approach, Rosenberg said.</p><p>"We don't want this to be something people are afraid of," said Robin Lewy, the director of development at the Rural Women's Health Project, which was one of the 25 nonprofits collaborating with the SHARP report. Lewy added that social media should have a role in educating people about being tested for HIV and the disease in general.</p><p>Targeting different communities like churches is another recommended strategy. "We need to educate our ministers," said Marvene Edwards, 56, a Gainesville resident living with HIV who spoke at Friday's forum. "If they call it a curse, and someone in the audience is positive, then you're scarring them from the inside out."</p><p>"We need to sit down with the pastors because we are the ones dealing with it," Edwards continued, adding that it's important to convey the message that, "We can live with the virus. We don't have to let it dictate our lives."</p><p>Other challenges include combating prejudice among law enforcement officials, employers and medical providers who "profile" patients when deciding who should get tested for the virus. They often do not test middle-aged caucasian women, for example, Edwards said.</p><p>Robin Chatmon, 57, another Gainesville resident living with HIV, said she lost her job shortly after she was diagnosed with HIV. She'd been working as a certified nursing assistant in Lake City when one night she got a call from her supervisor telling her, without any explanation, that Chatmon's services were no longer needed.</p><p>"As a nurse, she should have known that HIV doesn't spread through touch, that I can cook dinner for you and you're not going to get it," Chatmon said.</p><p><i>Contact Kristine Crane at 338-3119 or kristine.crane@gvillesun.com.</i></p>